Direct Supply Direct Choice DSDC2CA User manual

Please keep and refer to this Owner’s Manual.
Thank you for purchasing a Direct Supply®Direct Choice™ Analog TENS
Device from Direct Supply®Equipment & Furnishings®. Please read this
entire guide carefully and keep it for future reference. This guide will provide
you with instructions, warnings, warranty information- and other important
information about your Direct Supply Direct Choice Analog TENS Device.
Share this information with your housekeeping, nursing and maintenance
staff to help ensure the Analog TENS Device is used and cared for properly.
Direct Supply®Direct Choice™
Analog TENS Device
Model #DSDC2CA
Owner’s Manual

2
Table of Contents
Introduction..........................................................................3
Definitions and Symbols.....................................................3
Safety Notices – Warnings and Cautions .......................4-6
Contraindications.................................................................7
Product Description.............................................................8
Technical Specifications......................................................9
Replacement Parts & Accessories....................................10
Functions and Use ........................................................11-19
Battery Information ...........................................................20
Care and Maintenance.......................................................21
Troubleshooting.................................................................21
Limited Warranty..........................................................22-23
Customer Service...............................................................24

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Introduction and
Definitions and Symbols
Introduction
Thank you for purchasing this Direct Supply Direct Choice
Analog TENS Device from Direct Supply Equipment &
Furnishings, a division of Direct Supply, Inc. In this owner’s
manual, you’ll find important information that you should
read before using this device. Please keep this manual
available for future reference. Should you have any questions,
please contact your Direct Supply Equipment & Furnishings
account manager.
Transcutaneous Electrical Nerve Stimulation (TENS) is a non-
invasive, drug-free method to help control pain. TENS uses
tiny electrical impulses sent through the skin to nerves to
modify pain perception. TENS does not cure any physiological
problem; it only helps control the pain. TENS does not work for
everyone; however, in most patients it is effective in helping to
reduce or eliminate the pain, which may allow an individual to
return to normal activity.
Definitions and Symbols
NOTE: Indicates a tip.
• Attention. Read the instructions.
WARNING: Calls attention to a potential danger that requires
correct procedures or practices in order to prevent personal injury.
CAUTION: Indicates correct operating or maintenance
procedures in order to prevent damage to or destruction of
the equipment or other property
DEVICE: Your Direct Supply Direct Choice Analog TENS Device
YOU and YOUR: The facility, community or other entity that
has purchased the device.
WE, US and OUR: Direct Supply Manufacturing, Inc.
: Degree of Electrical Protection BF
: Direct Current (DC power source)

4
Check your Direct Supply Direct Choice Analog TENS Device
each week based on the following checklist:
1. Check the device for external damage, such as deformation
of the housing and damaged or defective output sockets.
2. Check the device for defective operating elements, such as
the switches or knobs. Check the legibility of labels.
3. Check that the LED is illuminated when its channel is turned on.
4. Check the usability of accessories. Check that the cables
and electrodes are not damaged.
5. If the device appears to be damaged in any way, do not
use the device and contact Direct Supply Equipment &
Furnishings for trouble-shooting assistance.
•WARNINGS
Read and follow all directions and warnings before using
this device. Do not operate this device without first reading
and understanding this user manual. Damage, injury or even
death may result from improper use of this device or not
following directions and warnings. This device is intended
for use by trained and licensed healthcare or senior care
providers in normal, indoor conditions.
• CautionshouldbeusedinapplyingTENStopatients
suspected of having heart disease. Further clinical data is
needed to show there are no adverse results.
• TENSdeviceshavenoAP/APGprotection.Donotuseitinthe
presence of explosive atmosphere and flammable mixture.
• ThesafetyofTENSdevicesforuseduringpregnancyorbirth
has not been established. Do not use TENS during pregnancy.
• TENSisnoteffectiveforpainofcentralorigin.(This
includes headache.)
• TENSdeviceshavenocurativevalue.
Safety Notices –
Warnings and Cautions

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• TENSisasymptomatictreatmentandassuchsuppresses
the sensation of pain which would otherwise serve as a
protective mechanism.
• Electronicmonitoringequipment(suchasEGGmonitors
andEGGalarms)maynotoperateproperlywhenTENS
stimulation is in use.
• Thereshouldbeaprominentlyplacedstatementwarning
that stimulus delivered by this device may be sufficient to
cause electrocution. Electrical current of this magnitude
must not flow through the thorax because it may cause a
cardiac arrhythmia.
• Donotplaceelectrodesonthefrontofthethroatasspasm
of the Laryngeal and Pharyngeal muscle may occur.
• Careshouldbetakensothatwhenoperatingpotentially
dangerous machinery the stimulator controls are not
changed abruptly.
• Keepthisdeviceoutofthereachofchildrenandindividuals
with cognitive impairment.
• Donotusewhilesleeping.
• Neveruseinenvironmentswithhighhumiditysuchasin
the bathroom or when having a bath or shower.
• Electrodesshouldneverbeplacedovertheeyes,inthe
mouth, near the genitals or internally.
• Skinirritationandelectrodeburnsarepossibleadverse
reactions. If either occurs, discontinue use and consult
your physician.
• Residentswithanimplantedelectronicdevice(forexample,
a pacemaker) should not undergo TENS treatment without
first consulting a doctor. The same applies to patients with
any metallic implants.

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• Thisdeviceshouldnotbeusedwhiledriving,operating
machinery, close to water, or during any activity in which
involuntary muscle contractions may put the user at undue
risk of injury.
• Federallawrestrictsthisdevicetosalebyorontheorder
of a physician. This device is for use under the order of a
healthcare practitioner licensed by your state.
• Ifthedeviceappearstobedamagedinanyway,donot
use the device and contact Direct Supply Equipment &
Furnishings for trouble-shooting assistance.
•CAUTIONS
• Isolatedcasesofskinirritationmayoccuratthesiteof
electrode placement following long-term application.
Effectiveness is highly dependent upon patient selection by
a person qualified in the management of pain patients. This
device should be used under the supervision of a licensed
healthcare professional.
• Possibleallergicreactiontogel,skinirritationandelectrode
burn are potential adverse reactions.
• IfTENStherapybecomesineffectiveorunpleasant,
stimulation should be discontinued until its use is
reevaluated by a licensed healthcare professional.
• Alwaysturnthedeviceoffbeforeapplyingorremoving
electrodes.
Safety Notices –
Warnings and Cautions (cont.)

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• Thisdeviceshouldnotbeusedforsymptomaticlocal
pain relief unless etiology is established or unless a pain
syndrome has been diagnosed.
• TENSisnotrecommendedforpatientswithknownheart
disease without physical evaluation of risk.
• Thisdeviceshouldnotbeusedwhencancerouslesionsare
present in the treatment area.
• Stimulationshouldnotbeappliedoverswollen,
infected, inflamed areas or skin eruptions (e.g. phlebitis,
thrombophlebitis, varicose veins, etc.).
• Electrodesmustnotbeappliedtositesthatmightcause
current/stimulationtoflowthroughthecarotidsinusregion
(anterior neck) or transcerebrally (through the head).
• Donotusethisdeviceifthepatienthasademand-type
cardiac pacemaker or any implanted defibrillator.
• Thisdeviceshouldnotbeusedoverpoorlyenervatedareas.
• Epilepsy.
• Seriousarterialcirculatoryproblemsinthelowerlimbs.
• Abdominaloringuinalhernia
Contraindications

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The Analog TENS Device is a battery-operated pulse
generator that sends electrical impulses through electrodes
to the body and reaches the nerves causing pain. The
device is provided with two controllable output channels,
each independent of each other. An electrode pair can be
connected to each output channel.
The electronics of the Analog TENS Device create electrical
impulses. The intensity, duration, number per second and
modulation may be altered with the controls or switches. Dial
controls are very easy to use and the slide cover prevents
accidental changes in the setting.
Device Description
cap
lead connector
intensity control
(on/offswitch)
LED
mode
pulse width
pulse rate
timer
battery strip
battery compartment

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Specification Technical Description
Channels Dual, isolated between channels
Pulse Amplitude Adjustable, 0-80 mA peak
into 500 ohm load each channel
Pulse Rate Adjustable from 2 to 150 Hz
Pulse Width Adjustable from 30 to 260 µs
Modulation Mode Pulse rate is automatically varied in
a cyclic pattern over an interval of
nominally 10 Seconds (at 150Hz).
Pulse rate decreases linearly over a
period of 4 seconds from the control
setting value to a value which is
40% less. The lower pulse rate will
continue for 1 second, then increase
linearly over a 4-second period to
its original value. The original pulse
rate will then continue for 1 second.
The cycle is then repeated.
Burst Mode Bursts occur twice every second.
Waveform Asymmetrical bi-phasic square pulse
Timer 15 minutes, 30 minutes, continuous
Voltage 0 to 40 V (Load: 500 ohms)
Max Charge per pulse 20 micro-coulombs
Power Supply One 9V battery
Battery Life Approximately 50 hours
Size 3.74"L x 2.56"W x 0.93"H
Weight 4.06 oz. (battery included)
Technical Specifications

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Please contact your Direct Supply Equipment & Furnishings
account manager to order replacement parts or accessories
for your Analog TENS Device. Only Direct Supply Direct
Choice accessories are intended for use with this device.
Available accessories may include:
• Electrodeleads
• Electrodes
• Beltclip
• Batterycasecover
• Leadconnector
• MainPCB
• Intensityknob
• B-N-Mswitch
• Pulsewidthorpulserateadjustmentknob
• Owner’sManual
• Carryingcase
Replacement Parts & Accessories

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1.Makesurethatbothintensitycontrol(ON/OFFSwitch)
knobs are in the “Off” position. Insert the 9V battery into
the device’s battery compartment. Make sure to remove
the plastic seal on the 9V battery. Line up the positive and
negative terminals on the battery with their corresponding
terminals in the device.
2. Insert the lead wires into the lead wire sockets on top of
the device.
3. Open the electrode package. Then insert each lead wire
pin into the pig tail of the electrodes.
4. Place the electrode on the resident’s body.
5. Slowly turn on the device by rotating the intensity control
(ON/OFFSwitch)knobs.
6. Select the mode and settings as directed by your licensed
healthcare professional.
7. Slowly increase or decrease the intensity as directed by
your licensed healthcare professional by rotating the
intensitycontrol(ON/OFFSwitch)clockwisetoincrease,
counterclockwise to decrease.
8. After treatment, turn the device off by rotating the intensity
control(ON/OFFSwitch)counterclockwisetothezerosetting
Pulse duration:
Wider pulse duration settings will deliver stronger stimulation
for any given intensity setting. As mentioned in the “Adjusting
the Controls on the Analog TENS Device” section, by using
a combination of intensity and pulse duration, it is felt that
various pulse widths are capable of stimulating different
groups of nerve fibers. The choice of which pulse duration to
use is partially dependent upon the Treatment Mode selected
(refer to the appropriate section).
Functions and Use

12
Pulse Rate:
The Pulse Rate (hertz or pulses per second) chosen depends
greatly upon the type of electrode placement given to the
patient. When using contiguous and dermatome electrode
placements (i.e. stimulating directly through the area of pain
or localized enervation), a quick pulse rate (setting greater
than 80Hz on the Pulse Rate Control) is typically desired. The
patient should not perceive individual pulses but rather have
the sensation of steady continuous stimulation. Despite any
general recommendations, individual patients may require
slight variations in the device settings, according to the nature
of their condition.
Treatment Mode:
Normal or Conventional TENS offers the practitioners
complete control over all the various treatment parameters
of the instrument. Burst Mode is analogous to the Low Rate
TENS technique except the low frequency individual pulses
are replaced by individual “bursts” of 7-10 individual pulses.
It is thus a combination of Conventional TENS and Low
Rate TENS. In Burst Mode, the treatment frequency is fixed
by the instrument and is not adjustable with the Frequency
Rate control. Modulated Mode attempts to prevent nerve
accommodation by continuously cycling the treatment
intensity. When using Modulated Mode, increase the intensity
only when the unit is at the maximum intensity of the
modulation cycle.
Time Duration:
The onset of pain relief should occur shortly after the intensity
setting has been determined. However, in some cases pain
relief may take as long as 30 minutes to achieve. TENS
units are typically operated for long periods of time, with
a minimum of 20- 30 minutes and in some post-operation
Functions and Use (cont.)

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protocols, as long as 36 hours. In general, pain relief will
diminish within 30 minutes of the cessation of stimulation.
Attachment of Electrode Lead Wires:
The wires provided with the device
insert into the jack sockets located
on top of the device. Holding the
insulated portion of the connector,
push the plug end of the wire into
one of the jacks (see drawing); one
or two sets of wires may be used.
After connecting the wires to the stimulator, attach each
wire to an electrode. Use care when you plug and unplug
the wires. Jerking the wire instead of holding the insulated
connector body may cause wire breakage.
• CAUTION: Do not insert the plug of the patient lead wire
into the AC power supply socket.
Electrode Options
The electrodes are disposable and should be routinely
replaced when they start to lose their adhesive nature. If you
are unsure of your electrode adhesive properties, discard
the existing electrodes and order replacement electrodes.
Replacement electrodes should be re-ordered through or on
the advice of a licensed healthcare professional to ensure
proper quality. Follow application procedures outlined in
electrode packing, to maintain optimal stimulation and to
prevent skin irritation.
Electrode Placement
The placement of electrodes can be one of the most important
parameters in achieving success with TENS therapy. Of utmost
importance is the willingness of the clinician to try the various
styles of electrode placement to find which method best fits

14
the needs of the individual patient. Contiguous placement is
the most common placement technique. It involves placing
the electrodes alongside the area of localized pain site, in such
a way as to direct the flow of current through or around the
area of pain. In a single channel application, this would involve
placing each pad on either side of the pain site if the pain is
localized on a limb and deep within the tissue. Pad placement
on the posterior and anterior aspects of the affected limb will
typically allow the current to flow completely through the limb
and thus through the endogenous pain site. With a two channel
application, the clinician may either direct the current flow to
cross through the pain site or, in what is called the “bracket”
method, allowing the current flow on either side of the
painful area, generally through the nerve branches that feed
into the pain site.
Application of Adhesive Electrodes
Application:
• Cleananddrytheskinattheprescribedareathoroughly
with soap and water prior to application of electrodes.
• Inserttheleadwireintothepinconnectoronthe
pre-wired electrodes.
• Removetheelectrodesfromtheprotectivelinerandapply
the electrodes firmly to the treatment site.
Removal:
• Liftattheedgeofelectrodesandpeel;donotpullonthe
lead wires because it may damage the electrodes.
• Placetheelectrodesonthelinerandremovetheleadwire
by twisting and pulling at the same time.
Functions and Use (cont.)

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Care and Storage:
• Betweenuses,storetheelectrodesintheresealedbagina
cool dry place.
• Itmaybehelpfultoimproverepeatedapplicationby
spreading a few drops of cold water over the adhesive and
turn the surface up to air dry.
• CAUTION: Over Saturation with water will reduce the
adhesive properties.
•WARNING:
• OnlyusethedevicewithDirectSupplyDirectChoice
electrodes.
• Donotapplyelectrodestobrokenskin.
• Theelectrodesshouldbediscardedwhentheynolonger
adhere to the skin.
• Theelectrodesareintendedforsinglepatientuseonly.
• Ifirritationoccurs,discontinueuseandconsultyourclinician
or other licensed healthcare professional.
• Readtheinstructionsforuseofself-adheringelectrodes
before application.
Tips for Resident Skin Care
To avoid skin irritation, especially if the resident has sensitive
skin, follow these suggestions:
• Washtheareaofskinwhereyouwillbeplacingthe
electrodes, using mild soap and water before applying
electrodes, and after taking them off. Be sure to rinse soap
off thoroughly and dry skin well.
• Excesshairmaybeclippedwithscissors;donotshave
stimulation area.
• Wipetheareawiththeskinpreparationyourclinicianhas
recommended. Let this dry. Apply electrodes as directed.

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• Manyskinproblemsarisefromthe“pullingstress”from
adhesive patches that are excessively stretched across the
skin during application. To prevent this, apply electrodes
from center outward; avoid stretching over the skin.
• Tominimize“pullingstress,”tapeextralengthsoflead
wires to the skin in a loop to prevent tugging on electrodes.
• Whenremovingelectrodes,alwaysremovebypullinginthe
direction of hair growth.
• Itmaybehelpfultorubskinlotiononelectrodeplacement
area when not wearing electrodes.
• Neverapplyelectrodesoverirritatedorbrokenskin.
Adjusting the Controls on the Analog TENS Device:
• SlideCover:Aslide-onpanelcovercoversthecontrolsfor
Pulse Width, Pulse Rate, Mode Selector, and Modulation
Selector. A licensed healthcare professional may wish to set
the controls and request that the cover is left in place.
• DisplayLED:EachoftheLEDsilluminateswheneverthe
electronics of the device create a current impulse. Due to
the capacity of the human eye, the illumination of the lamp
can only be recognized up to a frequency of approximately
30 Hz. At higher frequencies, the lamp will appear to be
constantly illuminated.
Functions and Use (cont.)
LED
COVER

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• On/OffSwitchandIntensityControl:Ifbothcontrolsare
in the off-position (white markings on the housing), the
device is switched off. By turning the controls clockwise,
the appropriate channel is switched on and the impulse
display led will illuminate and begin to pulse according
to the frequency set. The current strength of the impulses
transmitted to the electrodes increases further when the
control is turned clockwise. To reduce the current strength
or switch the device off, turn the controls counter clockwise
to the required setting or “Off” position.
• LeadConnector:Connectionoftheelectrodesismadewitha
two-lead connector. The device must be switched off before
connecting the cables. Both intensity controls must be at the
“Off” position. Electrodes must be pressed firmly on the skin.
PLUG
LEAD CONNECTOR
Turn Power On
Adjust Intensity
Turn
Power Off

18
• ModeControl:Exposethecontrolsbyslidingfrontcover
down from top of unit. This switch has 3 positions: B for
burst stimulation, N for constant stimulation, and M for
modulation stimulation. Push the Mode Selector until
engaged in position desired.
• PulseRateControl:Thisdialdetermineshowmany
electrical impulses are applied through the skin each
second. By turning these controls, the number of current
impulses per second (Hz) for both channels can be
continually adjusted. Unless otherwise instructed, turn the
pulse rate control to the 70-120 Hz range.
Functions and Use (cont.)

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• PulseWidthControl:Thisdialadjuststhelengthoftime
each electrical signal is applied through the skin, which
controls the strength and sensation of the stimulation. If no
instructions regarding the pulse width are given in therapy,
set the control to the suggested 70-120 µS setting.
• TimerControl:TreatmenttimeofTENScanbepresetwith
Timer Control. This switch has 3 positions, 15, 30 and C
(Continuous). Push the Timer Control until engaged in
position desired.

20
Check/Replace Battery
Over time, in order to ensure the functional safety of TENS,
changing the battery is necessary. If you suspect the device
is not functioning correctly due to a low battery, immediately
discontinue use until the battery has been replaced.
1. Make sure that both intensity controls are switched to
off position.
2. Slide the battery compartment cover and remove.
3. Remove the battery from the compartment.
4. Insert a new battery into the compartment. Note the polarity
indicated on the battery and in the compartment.
5. Replace the battery compartment cover and slide to close.
6. Discard the old battery in accordance with state and
local regulations.
The Direct Supply Direct Choice Analog TENS Device can
be used with a rechargeable battery when necessary. If you
use rechargeable batteries, please follow the instructions
accompanying the batteries.
NOTE: Rechargeable batteries are not included.
Prior to the use of a new unit, the rechargeable battery
should be charged according to the battery manufacturer’s
instructions. Before using the battery charger, read all
instructions and cautionary markings on the battery and in
this Owner’s Manual. After being stored for 60 days or more,
the batteries may lose their charge. After long periods of
storage, batteries should be charged prior to use.
Battery Information